Limits...
Effect of vitamin-D analogue on albuminuria in patients with non-dialysed chronic kidney disease stage 4-5: a retrospective single center study.

Jørgensen HS, Winther S, Povlsen JV, Ivarsen P - BMC Nephrol (2012)

Bottom Line: A 12% reduction in 24 h albuminuria was seen after starting treatment.In 19 patients with no change in renin-angiotensin-aldosteron-system (RAAS) inhibition, the reduction in albuminuria was 16%.The present study supports experimental and clinical data on antiproteinuric actions of activated vitamin D analogues, and suggests that this may be a class-effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nephrology, Aarhus University Hospital, Aarhus N DK-8200, Denmark.

ABSTRACT

Background: The vitamin D receptor activator paricalcitol has been shown to reduce albuminuria. Whether this is a unique property of paricalcitol, or common to all vitamin D analogues, is unknown. The primary aim of this study was to evaluate the effect of alfacalcidol on proteinuria, measured as 24 hour (24 h) albuminuria, in patients with chronic kidney disease (CKD) stage 4-5 being treated for secondary hyperparathyroidism (sHPT).

Methods: A retrospective single-center study including adult patients with CKD 4-5, undergoing treatment for sHPT with alfacalcidol, with macroalbuminuria in minimum one 24 h urine collection. Patients were identified in a prospectively collected database of all patients with S-creatinine > 300 μM or creatinine clearance < 30 ml/min. The observation period was from 1st of January 2005 to 31st of December 2009. Phosphate binders and alfacalcidol were provided to patients free of charge.

Results: A total of 146 macroalbuminuric patients were identified, and of these, 59 started alfacalcidol treatment during the observation period. A 12% reduction in 24 h albuminuria was seen after starting treatment. In 19 patients with no change in renin-angiotensin-aldosteron-system (RAAS) inhibition, the reduction in albuminuria was 16%. The reduction remained stable over time (9%) in a subgroup of patients (n = 20) with several urine collections before and after the start of alfacalcidol-treatment.

Conclusion: The present study supports experimental and clinical data on antiproteinuric actions of activated vitamin D analogues, and suggests that this may be a class-effect.

Show MeSH

Related in: MedlinePlus

Changes over time in 20 patients with two 24 h urinary collections both before and after starting treatment with alfacalcidol. 1A: 24 h albuminuria, 1B: Creatinine clearance, 1C: S-phosphate, 1D: S-calcium and 1E: S-PTH. Data shown as median, Box 25 and 75% and whiskers 5 and 95%.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3475058&req=5

Figure 1: Changes over time in 20 patients with two 24 h urinary collections both before and after starting treatment with alfacalcidol. 1A: 24 h albuminuria, 1B: Creatinine clearance, 1C: S-phosphate, 1D: S-calcium and 1E: S-PTH. Data shown as median, Box 25 and 75% and whiskers 5 and 95%.

Mentions: Results for this VDRA + subgroup are shown in Figure 1. Of the 59 patients who started alfacalcidol (VDRA+), 20 patients had at least two 24 h urine collections both before and after initiation of treatment. For this subgroup, the observation period was 324 days (median, range 210–819). Mean age was 57.8 years (range 30–83) with 65% males. Underlying renal diseases were: Chronic glomerulonephtis (7), unknown (5), diabetes (2), hypertension (2), polycystic kidney disease (2), tubulointerstitiel nephropathy (1) and obstructive nephropathy (1). Their average dose of alfacalcidol increased from 2.8 ± 1.6 μg/week to 3.5 ± 2.3 μg/week.


Effect of vitamin-D analogue on albuminuria in patients with non-dialysed chronic kidney disease stage 4-5: a retrospective single center study.

Jørgensen HS, Winther S, Povlsen JV, Ivarsen P - BMC Nephrol (2012)

Changes over time in 20 patients with two 24 h urinary collections both before and after starting treatment with alfacalcidol. 1A: 24 h albuminuria, 1B: Creatinine clearance, 1C: S-phosphate, 1D: S-calcium and 1E: S-PTH. Data shown as median, Box 25 and 75% and whiskers 5 and 95%.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475058&req=5

Figure 1: Changes over time in 20 patients with two 24 h urinary collections both before and after starting treatment with alfacalcidol. 1A: 24 h albuminuria, 1B: Creatinine clearance, 1C: S-phosphate, 1D: S-calcium and 1E: S-PTH. Data shown as median, Box 25 and 75% and whiskers 5 and 95%.
Mentions: Results for this VDRA + subgroup are shown in Figure 1. Of the 59 patients who started alfacalcidol (VDRA+), 20 patients had at least two 24 h urine collections both before and after initiation of treatment. For this subgroup, the observation period was 324 days (median, range 210–819). Mean age was 57.8 years (range 30–83) with 65% males. Underlying renal diseases were: Chronic glomerulonephtis (7), unknown (5), diabetes (2), hypertension (2), polycystic kidney disease (2), tubulointerstitiel nephropathy (1) and obstructive nephropathy (1). Their average dose of alfacalcidol increased from 2.8 ± 1.6 μg/week to 3.5 ± 2.3 μg/week.

Bottom Line: A 12% reduction in 24 h albuminuria was seen after starting treatment.In 19 patients with no change in renin-angiotensin-aldosteron-system (RAAS) inhibition, the reduction in albuminuria was 16%.The present study supports experimental and clinical data on antiproteinuric actions of activated vitamin D analogues, and suggests that this may be a class-effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nephrology, Aarhus University Hospital, Aarhus N DK-8200, Denmark.

ABSTRACT

Background: The vitamin D receptor activator paricalcitol has been shown to reduce albuminuria. Whether this is a unique property of paricalcitol, or common to all vitamin D analogues, is unknown. The primary aim of this study was to evaluate the effect of alfacalcidol on proteinuria, measured as 24 hour (24 h) albuminuria, in patients with chronic kidney disease (CKD) stage 4-5 being treated for secondary hyperparathyroidism (sHPT).

Methods: A retrospective single-center study including adult patients with CKD 4-5, undergoing treatment for sHPT with alfacalcidol, with macroalbuminuria in minimum one 24 h urine collection. Patients were identified in a prospectively collected database of all patients with S-creatinine > 300 μM or creatinine clearance < 30 ml/min. The observation period was from 1st of January 2005 to 31st of December 2009. Phosphate binders and alfacalcidol were provided to patients free of charge.

Results: A total of 146 macroalbuminuric patients were identified, and of these, 59 started alfacalcidol treatment during the observation period. A 12% reduction in 24 h albuminuria was seen after starting treatment. In 19 patients with no change in renin-angiotensin-aldosteron-system (RAAS) inhibition, the reduction in albuminuria was 16%. The reduction remained stable over time (9%) in a subgroup of patients (n = 20) with several urine collections before and after the start of alfacalcidol-treatment.

Conclusion: The present study supports experimental and clinical data on antiproteinuric actions of activated vitamin D analogues, and suggests that this may be a class-effect.

Show MeSH
Related in: MedlinePlus